CLMS CERTIFICATION EXAM 2 2026 EXAM
PREP STUDY GUIDE COMPREHENSIVE REVIEW
◉ What are the major medications reviewed in this unit needed for
traumatic brain injuries and spinal cord injuries? Answer: 1.
Phenytoin (Dilantin): controls seizures.
2. Propofol (dipravan): IV anesthetic, sedative, hypnotic.
3. Mannitol: osmotic diuretic to decrease ICP.
4. Baclofen: an antispasmodic to reduce s/s of spasticity.
5. Dantrolene: skeletal muscle relaxant to inhibit s/s of spasticity.
◉ Define DIC? Answer: Disseminated Intravascular Coagulation.
- an acute or chronic thrombotic and hemorrhagic disorder that
arises secondary to various disease states (as acute promyelocytic
leukemia, abruptio placentae, or major trauma) and is marked by
uncontrolled systemic coagulation resulting in thrombosis which in
acute cases typically leads to generalized bleeding due to depletion
of clotting factors and increased fibrinolysis.
◉ What are important lab values to know for DIC? Answer: Most
tested...
- Decreased platelet count.
- Increased aPTT (partial thromboplastin time, activated).
,- Increased D-dimer.
Others
- Increased Prothrombin time. (PTT)
- Increased thrombin time. (PT)
- Decreased Fibrinogen.
- Increased Fibrin degradation products (FDPs).
- Euglobulin clot lysis is less than or equal to one hour.
◉ What are s/s of DIC? Answer: Characterized by microthromboses
and bleeding!
- bleeding from mucous membranes (eyes, nose, mouth).
- thrombosis (blood clots) throughout the body.
◉ What 6 major conditions precipitate DIC? Answer: 1. sepsis.
2. trauma.
3. cancer.
4. shock.
5. ABRUPTIO PLACENTAE.
6. allergic reactions.
,◉ What medication is given to patients experiencing DIC? Answer:
Heparin!
Why?
- prevents further clots/coagulation.
- buys time to get the clotting factors replenished.
- use a pump to administer and have another nurse witness/sign off.
- reversal agent is protamine sulfate (no more than 50mg can be
given).
- drug interactions with alteplase, cephalosporins, penicillins, and
warfarin.
◉ How do you calculate cerebral perfusion pressure? Answer: CCP =
MAP - ICP
Cerebral perfusion pressure = Mean arterial pressure - Intracranial
pressure.
◉ How do you calculate mean arterial pressure? Answer: MAP =
(SBP + 2DBP)/3
Mean arterial pressure = (systolic BP + (2 x diastolic BP))/3
, ◉ What is Beck's Triad and what does it indicate? Answer: 1. JVD
2. Muffled heart sounds
3. low blood pressure (hypotension)
Indicates: CARDIAC TAMPONADE.
◉ Define cardiac tamponade? What are the s/s? Answer: Definition:
buildup of fluid within the pericardial sac surrounding the heart.
This places pressure on the heart making it more difficult for it to
beat.
s/s
- tachycardia due to low cardiac output.
- hypotension.
- pulsus peridoxus (SBP markedly higher during inhalation).
- chest pain.
- tachypnea (fast breathing).
- dyspnea (difficulty breathing).
- JVD.
- Hypotension.
- Heart sounds are muted/muffled.
PREP STUDY GUIDE COMPREHENSIVE REVIEW
◉ What are the major medications reviewed in this unit needed for
traumatic brain injuries and spinal cord injuries? Answer: 1.
Phenytoin (Dilantin): controls seizures.
2. Propofol (dipravan): IV anesthetic, sedative, hypnotic.
3. Mannitol: osmotic diuretic to decrease ICP.
4. Baclofen: an antispasmodic to reduce s/s of spasticity.
5. Dantrolene: skeletal muscle relaxant to inhibit s/s of spasticity.
◉ Define DIC? Answer: Disseminated Intravascular Coagulation.
- an acute or chronic thrombotic and hemorrhagic disorder that
arises secondary to various disease states (as acute promyelocytic
leukemia, abruptio placentae, or major trauma) and is marked by
uncontrolled systemic coagulation resulting in thrombosis which in
acute cases typically leads to generalized bleeding due to depletion
of clotting factors and increased fibrinolysis.
◉ What are important lab values to know for DIC? Answer: Most
tested...
- Decreased platelet count.
- Increased aPTT (partial thromboplastin time, activated).
,- Increased D-dimer.
Others
- Increased Prothrombin time. (PTT)
- Increased thrombin time. (PT)
- Decreased Fibrinogen.
- Increased Fibrin degradation products (FDPs).
- Euglobulin clot lysis is less than or equal to one hour.
◉ What are s/s of DIC? Answer: Characterized by microthromboses
and bleeding!
- bleeding from mucous membranes (eyes, nose, mouth).
- thrombosis (blood clots) throughout the body.
◉ What 6 major conditions precipitate DIC? Answer: 1. sepsis.
2. trauma.
3. cancer.
4. shock.
5. ABRUPTIO PLACENTAE.
6. allergic reactions.
,◉ What medication is given to patients experiencing DIC? Answer:
Heparin!
Why?
- prevents further clots/coagulation.
- buys time to get the clotting factors replenished.
- use a pump to administer and have another nurse witness/sign off.
- reversal agent is protamine sulfate (no more than 50mg can be
given).
- drug interactions with alteplase, cephalosporins, penicillins, and
warfarin.
◉ How do you calculate cerebral perfusion pressure? Answer: CCP =
MAP - ICP
Cerebral perfusion pressure = Mean arterial pressure - Intracranial
pressure.
◉ How do you calculate mean arterial pressure? Answer: MAP =
(SBP + 2DBP)/3
Mean arterial pressure = (systolic BP + (2 x diastolic BP))/3
, ◉ What is Beck's Triad and what does it indicate? Answer: 1. JVD
2. Muffled heart sounds
3. low blood pressure (hypotension)
Indicates: CARDIAC TAMPONADE.
◉ Define cardiac tamponade? What are the s/s? Answer: Definition:
buildup of fluid within the pericardial sac surrounding the heart.
This places pressure on the heart making it more difficult for it to
beat.
s/s
- tachycardia due to low cardiac output.
- hypotension.
- pulsus peridoxus (SBP markedly higher during inhalation).
- chest pain.
- tachypnea (fast breathing).
- dyspnea (difficulty breathing).
- JVD.
- Hypotension.
- Heart sounds are muted/muffled.
